Characteristic endoscopic findings in diagnosis in clinical practice.

Expert Rev Gastroenterol Hepatol

Department of Gastroenterological Endoscopy, Tokyo Medical University Hospital, Shinjuku, Japan.

Published: August 2024

AI Article Synopsis

  • Gastric cancer is a major health risk, and screening with high-vision endoscopy can significantly reduce mortality rates if done early.* -
  • In Japan, the Kyoto classification of gastritis categorizes risk factors based on endoscopic findings, dividing them into three groups: negative, past infection (inactive gastritis), and current infection (active gastritis).* -
  • Accurate evaluation of endoscopic findings is crucial; if signs of infection are present, reliable diagnostic tests like stool antigen tests and urea breath tests should be utilized for confirmation.*

Article Abstract

Introduction: is a major risk factor for gastric cancer. In addition to eradication therapy, early-phase detection of gastric cancer through screening programs using high-vision endoscopy is also widely known to reduce mortality. Although European and US guidelines recommend evaluation of atrophy and intestinal metaplasia by high-vision endoscopy and pathological findings, the guideline used in Japan - the Kyoto classification of gastritis - is based on endoscopic evaluation, and recommends the grading of risk factors. This system requires classification into three endoscopic groups: -negative, previous infection (inactive gastritis), and current infection (active gastritis). Major endoscopic findings in active gastritis are diffuse redness, enlarged folds, nodularity, mucosal swelling, and sticky mucus, while those in -related gastritis - irrespective of active or inactive status - are atrophy, intestinal metaplasia, and xanthoma.

Areas Covered: This review describes the endoscopic characteristics of current infection, and how characteristic endoscopic findings should be evaluated.

Expert Opinion: Although the correct evaluation of endoscopic findings related to remains necessary, if findings of possible infection are observed, it is important to diagnose infection by detection methods with high sensitivity and specificity, including the stool antigen test and urea breath test.

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Source
http://dx.doi.org/10.1080/17474124.2024.2395317DOI Listing

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